The present invention relates to a minimally invasive coronary bypass procedure which is the ideal operation for poor risk coronary artery patients. Existing techniques require either an extra-corporeal system or a time consuming anastomisis of the saphenosis vein to the coronary artery. In 1997, approximately 600,000 coronary artery bypasses were performed in the United States with a mortality rate of between 2% to 5%. While this mortality rate is relatively low, there is still room for improvement.
Accordingly, the present arterial procedure allows a surgeon to bypass an occluded coronary artery without an extra-corporeal system through a small chest incision and a graft insertion. The procedure provides a bypass vein, which is either a saphenous vein or of a synthetic material, having a first end sealingly secured to the occluded artery distal to the blockage by means of a novel barbed support. A second end of the bypass vein is secured to the occluded artery on the proximal side of the occlusion by means of a second one of the novel barbed support or by a stent to thereby establish unhindered blood flow.
The present arterial bypass procedure is performed under general anesthesia and routine preparation of the percutaneous approach. Through a limited left fifth intercostal space anteriorally, the chest is opened. Perocardium is incised and the coronary artery is identified. A needle is inserted into the designated coronary artery distal to the occlusion. This is followed by insertion of a guide wire and a peel-off sheath introducer. The bypass vein, mounted on a pusher device such as a coronary balloon, is then passed through the peel-off sheath. Under floroscopy guidance, the bypass vein is secured to the occluded artery distal to the occlusion while the peel-off sheath is removed. The opposite end of the bypass vein is then secured to the occluded vein proximal the occlusion, thereby bypassing the occlusion. The second end of the bypass vein is secured to the occluded vein by either a stent or a barbed support of the present invention.